Unleashing the Facts: Understanding and Treating Puppy Strangles

Kaylee Ferreira

Published by Dr. Kaylee Ferreira

Updated on

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What is Puppy Strangles?

The term puppy strangles refers to a condition known as canine juvenile cellulitis. The disease affects puppies up to the age of six months, and the exact cause is unknown. Enlarged lymph nodes and granulomatous inflammation of the skin result in acute onset swelling of the face and neck. 

The inflamed skin is painful as it develops small nodular lesions that become crusty with dried skin secretions. 

Cute puppy

The Causes of Juvenile Cellulitis

With such a disconcerting name, many readers may wonder what causes puppy strangles. The condition results in swollen submandibular lymph nodes that increase in size under the puppy’s chin, causing significant discomfort around the puppy’s neck, hence the name puppy strangles. 

The disease is thought to stem from an inappropriate immune-mediated overreaction to the puppy’s skin. The exact cause is unknown, but it is not contagious. Some research shows that the condition is possibly hereditary, and some breeds, such as Daschunds, Golden Retrievers, and Gordon Setters.

Despite arguments from some pet owners, no literature supports that vaccinations cause juvenile cellulitis. The clinical symptom’s onset coincides with primary puppy vaccinations, but owners must remember correlation does not signify causation.

Clinical Signs and Symptoms

Dogs affected by juvenile cellulitis start with signs of decreased activity levels and depressed appetite. As the condition progresses, the puppy’s face and neck swell and feel tender and warm. Pustules in the skin burst, forming crusty lesions and scabs that take a while to heal. 

The most common puppy strangles symptoms include:

  • Lethargy.
  • Fever. 
  • Lymphadenopathy – swollen lymph nodes under the chin and in the cervical area. 
  • Oozing, crusted, and purulent skin lesions around the muzzle, eyes, and ears. 
  • Joint inflammation, swelling, and lameness. 
  • Hair loss.

If left untreated, the inflammation progresses into a generalized condition spreading to the rest of the body, including the joints, paws, and perineal area. Rupture of the affected lymph nodes results in draining wounds that may lead to significant scarring.  

How Vets Diagnose the Condition

Juvenile cellulitis in puppies does not occur commonly, so vets will perform several tests to rule out other possible skin conditions. 

The vet takes a thorough history of the puppy’s diet, environment and onset of symptoms, and any relevant history of predisposed genetic conditions.

A skin scrape test helps to exclude conditions with similar clinical signs like mange, and fungal cultures help to rule out possible fungal infections such as ringworm. A skin tape test also helps to assess overall skin barrier health. The vet performs the tests in-house, and the results aid in excluding other diagnoses. 

Tests that specifically diagnose puppy strangles are more invasive, requiring sedation or anesthesia to perform a full-thickness skin biopsy. Histopathology is then applied to assess the specific inflammation occurring under the skin.

Puppy on green grass

Early Stage Puppy Strangles

The first sign of juvenile cellulitis results in acute swelling of the face and muzzle, which then progresses to several pustules, crusty bumps, or scratches over the neck, face, and ears. 

Juvenile Cellulitis Treatment Options

A puppy strangles treatment protocol aims to address autoimmune-related inflammation and requires immunosuppressive drugs. The puppy is also susceptible to secondary infections through their compromised skin barrier. So vets factor this in when treating the condition. 

Treating an overactive immune system requires medication that suppresses the immune response. The drug of choice is a glucocorticoid like Prednisone, which starts at a high dose and is slowly tapered down over a few weeks. 

The side effects of corticosteroids include lethargy, increased thirst and appetite, and increased urination frequency. If the side effects are not well tolerated, vets may prescribe other immunosuppressive drugs, such as Cyclosporine. 

Cyclosporine’s most common side effects include gastrointestinal symptoms like vomiting, diarrhea, and decreased appetite. 

When the skin barrier becomes inflamed or broken by self-trauma or primary skin lesions, it becomes susceptible to environmental pathogens. Bacterial, yeast, or fungal infections are the main culprits of secondary skin infections. 

Secondary fungal or bacterial infections complicate the treatment and may prolong the recovery time due to the compromised immune system and open wounds exposed to the environment. Vets will dispense additional antifungal medication or antibiotics if needed. 

Topical therapy helps to alleviate some of the symptoms, but always consult your vet before applying any home remedies or shampoos to ensure they aren’t contraindicated.

How Long Does it Take to Heal? 

Juvenile cellulitis in puppies carries a good prognosis, and after appropriate treatment, complete resolution of symptoms occurs within two to four weeks. If the clinical presentation of the disease is severe, then full recovery may take longer and result in more significant scarring.

Some Reader Questions Answered

Is Puppy Strangles Genetic?

Some genetic studies report elements of heritability for puppy strangles, so breeders need to disclose if parents suffered from the condition. The breed predisposition also suggests a part of genetic susceptibility for breeds such as Daschunds, Golden Retrievers, and Gordon Setters.

Is Puppy Strangles Contagious?

There is no evidence indicating that puppy strangles disease is contagious. No studies show any cross-infection from one dog to another or from a dog to a human. 

Can a Puppy Fully Recover From Juvenile Cellulitis?

Puppies suffering from the condition fully recover if they receive the correct treatment. Secondary bacterial or fungal infections are a risk factor that may complicate the disease as the skin barrier becomes compromised. 

The combination of immunosuppressive drugs and a secondary infection prolong recovery time.

What are the Long-Term Effects?

When considering the early onset age of puppy strangles, long-term effects pose a big concern for owners. The key to avoiding severe chronic effects is promptly treating the conditions once a vet confirms the diagnosis. 

The Prognosis

The prognosis for juvenile cellulitis is often good when treated swiftly and for the correct duration. Owners must comply with the treatment prescribed by their veterinarian to ensure the best outcome for the affected puppy. 

Recurrence of the disease is rare, but the treatment of choice remains tapered immunosuppressive doses of glucocorticoids, such as prednisone, combined with antibiotic therapy to control secondary bacterial infections.  

Puppies make a full recovery often and go on to lead happy and healthy lives. It is important to note that dogs that suffer from puppy strangles should not be considered good breeding stock.   

Golden doodle puppy

That’s a Wrap

Puppy strangles present owners with several frustrations as the condition taints their ideal experience of what should be a wonderful and memorable time for both pets and their owners. 

Administration of medication, additional vet visits, and potential secondary infections compound the challenges of the condition. Therefore, it is crucial that breeders remain open and honest with clients if their breeding dogs previously suffered from juvenile cellulitis or if they should not breed them again.

Juvenile cellulitis has a good prognosis if treated quickly, and owners remain compliant for the entire duration of the treatment protocol. Corticosteroids must never be stopped abruptly, and owners must complete the course according to the vet’s instructions. 

If your pet experiences severe side effects from the medications, contact your vet to explore alternative drugs.       

Loosening the grip of puppy strangles in a young dog is easier than it sounds if the condition is treated early. Owners may find comfort in the fact that recurrence is rare and there is a low risk of serious complications. 

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Kaylee Ferreira


Dr. Kaylee Ferreira, a South African vet from Johannesburg, excels in diverse veterinary roles. Founder of Kubuntu Veterinary Services, she's a dedicated animal lover and adventurer.


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